‘Married women, single men under 30 in Pakistan most likely to commit suicide’

Thousands of people, including men, women and teenagers, commit suicide in Pakistan every year where the ratio of depression and anxiety is four to five times higher as compared to the rest of the world, leading psychiatrists said on Wednesday but deplored that as suicide is considered a crime, it is highly unreported in Pakistan.

Speaking at various awareness activities in connection with World Mental Health Day 2019, leading psychiatrists of the country said the number of people with depression and anxiety stands at 33 percent in Pakistan, while in some areas, including the northern areas of Pakistan, as much as 66 percent of women are depressed while the ratio of suicides is also alarmingly high in those parts, including Ghizer and Hunza.

Terming depression the main cause of suicide, they urged people to seek medical assistance from trained and qualified mental health experts, help others in living a happy life to enjoy their own lives, live a simple life by eating a balanced diet, do daily exercise and refrain from drugs and tobacco to avoid having mental illnesses.

They were speaking at a seminar in connection with World Mental Health Day 2019, which was organised by the Department of Psychiatry, Jinnah Postgraduate Medical Centre. It was addressed by IGP Gilgit Baltistan Dr Sanaullah Abbasi, eminent psychiatrist Prof Haroon Ahmed, Executive Director JPMC Dr Seemin Jamali, Head of Psychiatry Department JPMC Prof Iqbal Afridi, eminent psychiatrist Prof Raza-ur-Rehman, President Karachi Press Club (KPC) Imtiaz Faran and others.

Dr Sanaullah Abbasi said that despite being highly educated and prosperous, the people of Hunza Valley were more prone to commit suicide and hundreds of lives could be saved annually by helping each other and giving hope to people who were depressed and had no way out but to commit suicide to get rid of their temporary miseries.

Executive Director Dr Seemin Jamali said suicide was a leading cause of death not only in Pakistan but also in the world where around one million people end their lives. She added that suicide had nothing to do with prosperity or social status as in some very advanced and prosperous countries like Japan, the ratio of suicides was very high. She urged the people to help each and try to save lives by doing charities, listening to others and encouraging them to deal with issues and problems.

Prof Iqbal AFridi, head of the JPMC’s Department of Psychiatry and president of the Pakistan Psychiatric Society, said that although medication and psychotherapy are necessary for mentally ill-patients with suicidal behaviour, folk wisdom can play a vital role.

“We listen to many songs which are pro-suicide; we should discourage such songs, because a person facing a depression-like situation and listening to such songs may become emotional and reach a high level of anxiety.”

“Let us promote Kachehries, social gatherings, motivational proverbs and anti-suicide poetry for motivating suicidal to enjoy life,” he said. “We all have experienced through social, print and electronic media that students are suffering from mental disorder and depression. We must integrate our program with educational institutes for educating and involving students in mental health promotion and suicide prevention for maximising impact through peer to peer learning.

“There is a dire need for campaigns aimed at improving mental health education in the general population. We may run programs focusing on increasing the ability to recognise risk, improving understanding of suicide causes and risk factors.” The involvement and role of academia and psychiatrists, awareness raising and interaction by public-private partnership were critical for addressing the issue, he said.

Renowned psychiatrist Prof Raza-ur-Rehman said, “Suicide is the permanent solution of a temporary problem.” He said depression was the leading cause of suicides in the world, including Pakistan. “Depression is four to five times higher in Pakistan as compared to rest of the world but reported suicides are very low, which shows that suicides are highly underreported in Pakistan as it is a criminal offence as per the Pakistan Penal Code.”

“In order to prevent suicides, we need to create such an environment where mental health can be discussed. Most importantly, common people should have easy access to mental health services,” he said and added that due to fear of harassment, social stigma, confidentiality in such sensitive cases and complicated legal procedures, such cases went unnoticed.

He said suicide is a serious public health problem, and we all need to work together and collaborate with each other. Meanwhile, at another event at Aga Khan University, experts said married women and single men under the age of 30 in Pakistan are among groups most likely to commit suicide. Research showed that Pakistan’s highest-risk groups for suicide were different to those in other parts of the world. In the West, single men between the age of 50 and 60 are most likely to take their own lives.

The event was part of a week of sessions and themed activities aimed at spreading awareness of the importance of suicide prevention. Speakers noted that in Pakistan, youths of working age, under the age of 30, are most likely to commit suicide. This suggests that employers have a role to play in tackling the public health threat of suicide, which claims about 800,000 lives a year globally, according to data from the World Health Organisation.

According to global figures, one person dies by suicide every 40 seconds with three out of four suicides occurring in low and middle income countries. They said companies needed to establish a culture where people could speak about their challenges and daily stresses without the fear of being judged. Forums where employees can openly share their concerns promote wellness in the workplace and reduce the threat of issues such as anxiety and burnout.

Shagufta Hassan, interim CEO of Aga Khan University Hospital, said companies should launch professional mentorship programmes so that vulnerable youths had someone they could seek advice from.

She also highlighted the importance of offices having counselling services where employees facing challenges could access additional help or be referred to professionals. Atiya Naqvi, a clinical psychologist, noted the importance of friends and family in supporting those going through a difficult time.

Naqvi said that the mere act of listening to a person’s problems helps reduce anxiety. She also spoke of the need to monitor one’s thought patterns and to communicate one’s concerns with those around them.

Dr Ayesha Mian, chair of the Department of Psychiatry at the AKU, noted that hopelessness and despair are feelings that often exist in people with suicidal ideation. She noted that being unable to cope with financial pressures, academic stresses, dysfunctional relationships and bullying are some of the determinants known to lead to passive or active thoughts of suicide.

“There is a myth that only those patients with mental health disorders will commit suicide,” said Dr Ayesha. “While more often than not, patients who die of suicide have a diagnosed psychiatric illness, there may be those who do not have a mental health disorder. We know that for every one person who takes their life there are ten people actively planning suicide and a 100 with suicidal ideation, which is why prevention efforts are so vital.”

She also spoke about how compassionate words and actions can help ease feelings of despondency that may lead to pervasive feelings of hopelessness and suicidality in those vulnerable.

“Talking about suicide doesn’t promote suicide,” Dr Ayesha explained. “We often underestimate the importance of listening and acting with compassion even though they help protect against a number of self-harming actions. It is important to listen with sincerity and without fear; if you don’t know what to do, ask the person, ‘how would you like me to help?’”

Over the course of the week, students and staff at the university participated in support group sessions and wellness camps designed to promote mental wellbeing. Students also held a “Kindness Walk” and organised a “Wall of Compassion” to showcase the importance of empathy and kindness in preventing harmful thoughts and actions.